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Stressful deadlines boost heart attack risk

The pressure of meeting a work deadline can produce a sixfold increase in the risk of suffering a heart attack over the course of the following day. And competition at work could double the ongoing risk, according to a new study.

Previous research has shown that intense anger, sexual activity and emotional stress can all lead to heart attacks. But this is the first time having an intense work deadline has been singled out as a trigger for heart attack over such a short timescale.

“This is potentially important for patients and for Swedish work law,” says lead author Jette Möller of the Karolinska Institutet in Stockholm, Sweden. “Changes in the labour market organisation have created more stress and people should be aware of the impact on health.” She cites workload, lower job security and increased competition in the workplace as factors.

The study questioned nearly 1400 heart attack survivors from the Stockholm area, aged 45 to 70, about the period leading up to their first heart attack. They were compared with a control group of about 1700 people who had not had a heart attack.

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The volunteers were asked questions about their work over the last year and over the days immediately before their heart attack. The questions included whether they had been criticised for their performance or lateness, been promoted or laid off, faced a high-pressure deadline at work, changed their workplace and whether their financial situation had changed.

Money worries

The results show that intense pressure over a short period increased the risk of a heart attack more than a build up of stress over an entire year, and that the heart attack can follow very soon after this spell of increased pressure. Amongst the heart attack group, 8% had faced a significant event at work less than 24 hours before their attack.

However, long-term changes also play a part. Taking on extra responsibility at work over the last year – if viewed negatively by the participant – increased the chance of a heart attack by almost four times in women and over six times in men. And a deterioration in financial situation tripled the risk of a heart attack amongst women.

George Fieldman, an expert in cognitive therapy and health psychology at Buckinghamshire Chilterns University College in the UK, says the sixfold increase in risk caused by meeting a deadline is massive, but not surprising.

He points out that previous research has shown that a person’s chance of suffering a heart attack is higher on a Monday morning. He adds these studies can help to pinpoint the stress risk factors for heart attacks. “It is difficult to unpick the details of what constitutes stress for different people in different situations,” he says.

The study shows that stress at work can pose a very real and immediate threat to health, Fieldman says, and adds&colon; “I must remember to take it easy.”

Journal reference&colon; Journal of Epidemiology and Community Health (DOI&colon; 10.1136/jech.2003.019349)